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Preoperative Chemotherapy Versus Preoperative Chemoradiotherapy for Stage III (N2) Non-Small-Cell Lung Cancer

Abstract

Purpose: To compare preoperative chemotherapy (ChT) and preoperative chemoradiotherapy (ChT-RT) in operable Stage III non-small-cell lung cancer. Methods and Materials: This retrospective study analyzed all patients with pathologically confirmed Stage III (N2) non-small-cell lung cancer who initiated preoperative ChT or ChT-RT at Duke University between 1995 and 2006. Mediastinal pathologic complete response (pCR) rates were compared using a chi-square test. The actuarial overall survival, disease-free survival, and local control were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was also performed. Results: A total of 101 patients who initiated preoperative therapy with planned resection were identified. The median follow-up was 20 months for all patients and 38 months for survivors. The mediastinal lymph nodes were reassessed after preoperative therapy in 88 patients (87%). Within this group, a mediastinal pCR was achieved in 35% after preoperative ChT vs. 65% after preoperative ChT-RT (p = 0.01). Resection was performed in 69% after ChT and 84% after ChT-RT (p = 0.1). For all patients, the overall survival, disease-free survival, and local control rate at 3 years was 40%, 27%, and 66%, respectively. No statistically significant differences were found in the clinical endpoints between the ChT and  More>>
Authors:
Higgins, Kristin; [1]  Chino, Junzo P; [1]  Marks, Lawrence B; [2]  Ready, Neal; [3]  D'Amico, Thomas A; [4]  Clough, Robert W; Kelsey, Chris R [1] 
  1. Department of Radiation Oncology, Duke University of Medical Center, Durham, NC (United States)
  2. Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC (United States)
  3. Department of Medicine, Division of Medical Oncology, Duke University of Medical Center, Durham, NC (United States)
  4. Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Duke University of Medical Center, Durham, NC (United States)
Publication Date:
Dec 01, 2009
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 75; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2009.01.069; PII: S0360-3016(09)00200-4; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; COMBINED THERAPY; LUNGS; MULTIVARIATE ANALYSIS; NEOPLASMS; RADIOTHERAPY; REGRESSION ANALYSIS; SURVIVAL CURVES; BODY; DISEASES; MATHEMATICS; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; RESPIRATORY SYSTEM; STATISTICS; THERAPY
OSTI ID:
21367557
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; IOBPD3; TRN: US10R0679099828
Availability:
Available from http://dx.doi.org/10.1016/j.ijrobp.2009.01.069
Submitting Site:
INIS
Size:
page(s) 1462-1467
Announcement Date:
Dec 22, 2010

Citation Formats

Higgins, Kristin, Chino, Junzo P, Marks, Lawrence B, Ready, Neal, D'Amico, Thomas A, Clough, Robert W, and Kelsey, Chris R. Preoperative Chemotherapy Versus Preoperative Chemoradiotherapy for Stage III (N2) Non-Small-Cell Lung Cancer. United States: N. p., 2009. Web. doi:10.1016/j.ijrobp.2009.01.069.
Higgins, Kristin, Chino, Junzo P, Marks, Lawrence B, Ready, Neal, D'Amico, Thomas A, Clough, Robert W, & Kelsey, Chris R. Preoperative Chemotherapy Versus Preoperative Chemoradiotherapy for Stage III (N2) Non-Small-Cell Lung Cancer. United States. doi:10.1016/j.ijrobp.2009.01.069.
Higgins, Kristin, Chino, Junzo P, Marks, Lawrence B, Ready, Neal, D'Amico, Thomas A, Clough, Robert W, and Kelsey, Chris R. 2009. "Preoperative Chemotherapy Versus Preoperative Chemoradiotherapy for Stage III (N2) Non-Small-Cell Lung Cancer." United States. doi:10.1016/j.ijrobp.2009.01.069. https://www.osti.gov/servlets/purl/10.1016/j.ijrobp.2009.01.069.
@misc{etde_21367557,
title = {Preoperative Chemotherapy Versus Preoperative Chemoradiotherapy for Stage III (N2) Non-Small-Cell Lung Cancer}
author = {Higgins, Kristin, Chino, Junzo P, Marks, Lawrence B, Ready, Neal, D'Amico, Thomas A, Clough, Robert W, and Kelsey, Chris R}
abstractNote = {Purpose: To compare preoperative chemotherapy (ChT) and preoperative chemoradiotherapy (ChT-RT) in operable Stage III non-small-cell lung cancer. Methods and Materials: This retrospective study analyzed all patients with pathologically confirmed Stage III (N2) non-small-cell lung cancer who initiated preoperative ChT or ChT-RT at Duke University between 1995 and 2006. Mediastinal pathologic complete response (pCR) rates were compared using a chi-square test. The actuarial overall survival, disease-free survival, and local control were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was also performed. Results: A total of 101 patients who initiated preoperative therapy with planned resection were identified. The median follow-up was 20 months for all patients and 38 months for survivors. The mediastinal lymph nodes were reassessed after preoperative therapy in 88 patients (87%). Within this group, a mediastinal pCR was achieved in 35% after preoperative ChT vs. 65% after preoperative ChT-RT (p = 0.01). Resection was performed in 69% after ChT and 84% after ChT-RT (p = 0.1). For all patients, the overall survival, disease-free survival, and local control rate at 3 years was 40%, 27%, and 66%, respectively. No statistically significant differences were found in the clinical endpoints between the ChT and ChT-RT subgroups. On multivariate analysis, a mediastinal pCR was associated with improved disease-free survival (p = 0.03) and local control (p = 0.03), but not overall survival (p = 0.86). Conclusion: Preoperative ChT-RT was associated with higher mediastinal pCR rates but not improved survival.}
doi = {10.1016/j.ijrobp.2009.01.069}
journal = {International Journal of Radiation Oncology, Biology and Physics}
issue = {5}
volume = {75}
place = {United States}
year = {2009}
month = {Dec}
}